skin : scabies 6 diagnosis

According to Handoko (2007), the diagnosis can be established if scabies found 2 of the 4 cardinal signs as follows:
• Proritus nokturna, means itching at night. This is caused by mites that activity was higher in the more humid conditions and higher temperatures, and it happened at night.
• Attacking a group of human beings. Where scabies not only suffered by the patient, but also about the entire family or transmitted to people - the closest.
• The discovery of the tunnel (kunikulus) in place predileksi lesions. Tunnels are usually white or gray - gray, straight line or curved - curved, with the average length - average 1 cm, and at the end of the tunnel is often found in vesicles, papules, or pustules.
• The discovery of mites, both in the form of eggs, larvae, or adults. This is the most diagnostic points.
From the clinical manifestations described above, which includes the classic scabies, still there are many forms - a special form of which can be found skabies (Rikyanto, 2001):
1. Scabies on the net (clean scabies)
Usually very hard to find the tunnel. Lice are usually lost due to bathe regularly.
2. Scabies in infants and children
Scabies lesions in children can be about the entire body, including the entire head, neck, palms, soles of the feet, and often secondary infection of impetigo, so that the tunnel ektima rare.
3. Scabies which is transmitted by animals
Sarcoptes scabiei canis variants can infect humans who work closely with these animals, such as farmers and pastoralists. Mild symptoms and will heal themselves when away from the animals - these animals and bathe with clean (Maskur, 2000).
4. Scabies nodular
Nodules due hipersensivitas reaction. The place is often subject to male genitalia, groin and axilla. Lesions that arise can stay a few weeks to several months, even up to a year despite having received anti scabies (Maskur, 2000).
5. Scabies incognito
Topical medication or systemic steroids may mask the symptoms and signs while scabies infestations remain. In contrast, treatment with topical steroids which can also cause long lesions intensified. This may be caused by the decline in cellular immune responses.
6. Scabies lying in bed (bed-ridden)
Patients with chronic diseases and elderly people who are forced to stay in bed may suffer a lesi limited scabies.
7. Scabies krustosa (Norwegian Scabies)
Eritrodermi picture Lesi form, accompanied skuama generalized, erythema, and nail dystrophy. There are many Krusta, this form easily transmitted because the population is very high Sarcoptes scabiei and itching is not prominent. Often occurs in older people and people who suffer from mental retardation (Down's syndrome), low skin sensation (leprosy, and tabes dorsalis syringomelia.